Galesburg medical student learns patient skills at Knoxville Clinic

The Southern Illinois University School of Medicine has released eight students into “the real world” this summer as part of the school’s Family Medicine Preceptorship Program. Among the aspiring doctors is Lance Hoffman, son of Martin and Michelle Hoffman of Galesburg, who is spendin...

The Southern Illinois University School of Medicine has released eight students into “the real world” this summer as part of the school’s Family Medicine Preceptorship Program.

Among the aspiring doctors is Lance Hoffman, son of Martin and Michelle Hoffman of Galesburg, who is spending his preceptorship experience with Dr. Mark DeYoung at the Knoxville Clinic.

“Our school likes us to go to smaller communities, especially near our homes, to get the opportunity to experience medicine in under-served or rural communities rather than a big academic institution,” said Hoffman on his second day at the clinic. “That’s what brings me here.”

Hoffman, a 2004 graduate of Galesburg High School, studied pre-med at Knox College until 2008 and is now at the end of his third year at SIU’s School of Medicine.

As a third-year med student, Hoffman has gone through various clerkships in the “different fields of medical specialties,” mostly in Springfield, but he said the only one “remotely close” to what he’s doing in Knoxville was his psychiatry rotation, which he spent at a mental institution in Alton.

“It’s interesting being in an office that only has one doctor in it,” said the 25-year-old. “It’s a lot different from what I’ve been experiencing, where it’s just a bunch of hallways with a doctor at every little station, but I like it. It’s been a lot of fun.”

Lessons learned

With DeYoung on vacation last week, Hoffman said Tuesday morning the office was “super busy” and that it seems the doctor is taking on more than normal to catch up.

But a passing staffer soon informed him that the heavy patient load was not unusual, presenting an inadvertent lesson.

“It’s busier than I thought it would be,” said Hoffman, contemplatively. “It seems like a lot for one doctor to handle, I think.

“Being from Galesburg, there’s a lot of doctors around, but I’d never considered how there’s a lot of smaller communities around Galesburg, and oftentimes they’ll have to come to Galesburg for treatment or whatever their medical needs are. So yeah, it’s interesting for me, realizing there’s a shortage of healthcare providers in the smaller, surrounding communities.”

For each patient, Hoffman, armed with a stethoscope, chart and a pen, does a full history and physical. He then presents the case to DeYoung before the two see the patient together.

“I’m definitely getting my own opportunity to work up the case and present my treatment plan with Dr. DeYoung,” said Hoffman. “Then if there’s any learning issues for me with each patient, we address those.”

Hoffman said the most challenging aspect, so far, of working in a single-doctor practice has been the “paperwork side of things.”

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Rather than writing up a report on each patient after seeing them, Hoffman has to see multiple patients before catching up on reports.

“That was interesting and new for me,” said Hoffman.

“I’ve seen other doctors having to stay late and work on paperwork, or dictations, but I as a medical student have never had to do that. It was a refreshing experience, especially coming toward the end of my training, it’s something I need to prepare for and get good at.”

The lesson learned was music to DeYoung’s ears. He said the challenge of managing time between patients and dictations is a “big part” of what he hopes Hoffman learns this summer.

“If I see one patient, and you’re my next patient, you want me on time,” said DeYoung. “That may mean that I’ll have to come back here after I’ve seen three or four patients, and then I’ll put all my documentation down and have to remember all the little nuances of what transpired in the exam room. That takes a little bit of time to learn those things.”

DeYoung said that if Hoffman left his office with one lesson, though, it would be in efficiency and practicality.

He said all the students he’s hosted over the years have been “book smart,” but much of what they encounter in his office is different from what they learn in school.

“They don’t realize there’s also going to be 40 or 50 or 60 phone calls throughout the day from patients, and you have to address those calls in between seeing 20 or 25 patients who come through the building each day,” said DeYoung.

“You have to learn how to put all of that knowledge together in as efficient an order as you possibly can, and that’s, to me, what my goal has to be for them. ... There will be the occasional pearl he’ll pick up, I’m sure, but it’s practicality and efficiency that we need to teach these kids.”

Soft skills

Hoffman said in addition to learning the hard skills of managing paperwork and the wide variety of procedures performed at the Knoxville Clinic, he also expects to pick up on some soft skills, such as how to get along with patients and, in some cases, comfort them.

“Dr. DeYoung is really personable, so I’m trying to pick up on how he does things like talking with patients,” said Hoffman. “That’s half the battle ... He’s good at getting eye to eye with all his patients, so that’s my goal at the end of this, to be able to do that, too.”

DeYoung, who completed his family practice clerkship in the Ann Arbor and Detroit areas in the 70s, said Hoffman’s positive attitude and willingness to learn will make hosting him this month an enjoyable experience.

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He said, having been a student himself “a number of years ago,” he is always willing to have students in the clinic.

Hoffman is scheduled to graduate med school in May 2012 when he will go on to advanced training in a specific area of medicine, lasting anywhere from three to seven years, before beginning practice.

“I’m still dabbling in a few different ideas and haven’t nailed down a specific hole, yet,” said Hoffman just before seeing the first patients Tuesday. “Luckily I’ve still got a few more months before I need to make any lifetime decisions.”

The one thing he is sure of, though, is he will be a doctor when he grows up.